Underreporting of fatal occupational injuries in Catalonia (Spain)

Abstract
Background Thoroughness in a given health information system is one of its most important quality indicators. In Spain, in ∼30% of serious occupational injuries, there is no information on the final outcome. Aim To assess underreporting of fatal occupational injuries in Catalonia. Methods All serious occupational injuries (excluding commuting injuries) reported in Catalonia (Spain) between 1994 and 1998 (n = 7330) were linked with data from the Catalonian Mortality Register, 117 deaths being identified during the year following the injury date. In order to assess whether death could or could not have been related to the prior occupational injury, two experts examined these cases independently. Results The experts concluded (κ = 0.98) that 69 (59%) of these deaths were probably related to occupational injuries; the vast majority (n = 65) occurred within 3 months of the injury. This represents an accumulated risk of dying of ∼1% for the total of serious injuries, not varying with economic activity or job category. However, this risk varied depending on the form of accident, and the site and nature of the injury. Conclusions Occupational injury cases, especially serious ones, should be followed up over at least 3 months. These results suggest the importance of carrying out active case-finding and of incorporating the death certificate as one of the documents to be systematically reviewed in order to complete the statistics.

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